Selecting a trust-worthy agent who will ultimately be the decision-making authority for your medical care if something happens to you is an important decision. The goal is for your agent to make decisions in keeping with your preferences so that you receive the medical treatment you want.

In the majority of circumstances, this is what happens.

However, some states allow your agent to make decisions to direct or refuse health care interventions or withdraw treatment. In the event where there’s no clear answer, your agent will need to consider many things in order to act in your best interest. It could be the past conversations you’ve had, your personality type, or how you handled important health care issues in the past. This is no easy task when there is great uncertainty and doubt surrounding the circumstances.

What do my agents need to know?

To spare your agents from the confusion of having to make decisions that directly impact your life, it’s important to have a conversation with them now about your expectations and wishes if something were to happen to you. Consider some of these important questions to help guide that discussion.

  • What is most important to me in my life?
  • How important is it to me to avoid pain and suffering?
  • If I had to choose, would I rather live as long as possible, or avoid prolonged suffering or disability?
  • Would I rather be at home or in a hospital for the last days or weeks of my life?
  • Do I have religious, spiritual, or cultural beliefs that I want my agent and others to consider?
  • Do I wish to make a significant contribution to medical science after my death through organ or whole body donation? Have I already registered as a donor with a specific organization?

What kinds of decisions can my agent make for me?

Following are some decisions your agent could make on your behalf depending on your specific state laws.

  • Talk with physicians and other health care providers about my condition.
  • See my medical records and approve who else can see them.
  • Give permission for medical tests, medicines, surgery, or other treatments.
  • Choose where I receive care and which physicians and others provide it.
  • Decide to accept, withdraw, or decline treatments designed to keep me alive if I’m near death or unlikely to recover. I can choose to include guidelines and/or restrictions to my agent’s authority.
  • Agree or decline to donate my organs or my whole body if I’ve not already made this decision myself. This could include donation for transplant, research, and/or education. Decide what to do with my remains after I’ve died, if I haven’t already made plans.
  • Talk with my loved ones to help come to a decision (although my designated agent will have the final say).

What if I have not or cannot name an agent for my health care?

If you become unable to make your own health care decisions and have not named an agent in writing, your health care provider will ask a family member, friend, or guardian to make decisions for you. A majority of states have enacted surrogate consent laws that direct which of these individuals will be consulted and the extent of their decision-making powers.

There are reasons why you may want to name an agent rather than rely on the state to assign you a surrogate:

  • The person or people listed by this law may not be who you would want to make decisions for you.
  • Some family members or friends might not be able or willing to make decisions as you would want them to.
  • Family members and friends may disagree with one another about the best decisions.
  • Under some circumstances, a surrogate may not be able to make the same kinds of decisions that an agent can make.

If you have no one to name as your agent, make sure you talk to your health care providers and create written direction about what you want or do not want in the event of incapacitation. It’s a good idea to complete a living will which outlines your end-of-life wishes. See to it that a copy of your living will or a written document containing your wishes is given to your healthcare providers and noted in your file.